Methods: The Premier Perspective Comparative Database (PPCD), a US database with inpatient and hospital-affiliated outpatient data, was used to assess the clinical impact of zygomycosis (2005-2014). Hospitalizations with zygomycosis were identified by requiring the presence of the ICD-9 code 117.7 (inclusive of mucormycosis and phycomycosis) and/or microbiology diagnosis. Among patients with evidence suggestive of zygomycosis, prevalence estimates were then assessed for patients with and without evidence of ampothericin B and/or posaconazole utilization.
Results: A total of 775 inpatient visits were identified between 2005 and 2014 with an estimated prevalence (mean (range)) of 0.16 (0.12-0.20) per 10000 discharges. After the antifungal drug use criteria was applied, the number of visits were reduced to 555 with an estimated prevalence of 0.12 (0.09-0.17) per 10000 discharges. Among the 555 zygomycosis hospitalizations, 547 were identified via ICD-9 diagnosis code, 3 were a combination of ICD-9 code and microbiology data, and 5 were microbiology only. The mean patient age was 51.7 years and 63% were male. Lipid formulations of amphotericin B were the most commonly used antifungal (62%). The mean (SD) LOS was 26 (29) days with a mortality rate of 23% (defined using discharge state as expired). One-month all-cause readmission rate was 30% and the 3-month readmission rate was 37%.
Conclusion: Findings suggest up to a 23% increase in zygomycosis encounters over the past two decades. Additionally, the extensive healthcare utilization as reflected by hospital length of stay and increased risk for any readmission should be considered.
C. Yang, None
S. Kelkar, None
E. Lee, Astellas: Employee , Salary
A. Fan, Astellas: Employee , Salary
N. Azie, Astellas: Employee , Salary
J. Spalding, Astellas: Employee , Salary
D. Kontoyiannis, Merck: Consultant , Investigator and Scientific Advisor , Consulting fee , Research support and Speaker honorarium
Astellas: Consultant and Investigator , Consulting fee , Research support and Speaker honorarium
Pfizer: Consultant and Investigator , Research support and Speaker honorarium
FRG: Consultant , Consulting fee
Mylan: Speaker's Bureau , Speaker honorarium
Gilead: Speaker's Bureau , Speaker honorarium